Shahram Hariri, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019027705 Issued in IL

Practice address

430 W Erie St
Suite 200
Chicago, IL 60610-6914

Phone

(920) 838-1649

NPI assigned

Jun 18, 2008

Last updated

Jun 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1932360401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 FOREST GLEN DR",
            "address_2": "APARTMENT J",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148034",
            "telephone_number": "248-224-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606106914",
            "telephone_number": "920-838-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIRI",
        "first_name": "SHAHRAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019027705",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Praseetha Harilal
• Larissa Harima
• Matthew Harings, PSYD, MSCP
• Jaya Hariprasad
• Seenu Hariprasad
• Shamna Haris, M.D
• James Haritos
• Harivadan K Gandhi MD SC
• Danielle Harkavy, PT, DPT
• Emma Harkavy, LPC

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.